Tuesday, 15 April 2014

Asthma in Vitamin E points of view

By Kyle J. Norton

The widespread of incidence of asthma over large 20 years in South East Asian population, specially in children and aging group has caused some concerns to the government and scientific community. It may be due to over intake in artificial ingredients, polluted environment as well as intake foods  triggering the inflammatory allergens.
 Vitamin E,  a fat soluble vitamin, consisting eight different variants (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol) with varying levels of biological activity(2), found abundantly in corn oil, soybean oil, margarine, wheat germ oil, sunflower,safflower oils, etc. plays an important role in neurological functions and inhibition of platelet aggregation, regulation of enzymatic activity, free radical scavenger, etc..
General consensus suggestion of increased dietary vitamin E intake is associated with a reduced incidence of asthma, due its antioxidant status, but epidemiological studies, linking vitamin E in reduced risk and treatment of asthma have not been conclusive(a)(b)(c)(d)(e).

1. Serum levels of vitamin E
Serum levels of vitamin in asthmatic patients may be correlated to the occurrence of the diseases. The University of Tampere study of five European rural settings with Children of 1133 mothers recruited during pregnancy, showed no associated of with allergies or asthma by 6 years of age regardless the concentration of vitamin E(1). and the study of the Yamaguchi University, also indicated no correlation of levels of vitamin E and asthma in the a total of Of 2796 students attending schools in Shunan, Japan, in 2006.(1a). The University of Medical Sciences study indicated other wise as treatment of fluticasone and vitamin E (50mg/day) showed an significantly increased of Serum level of Vitamin E, with improved FEV1 and FEV1/FVC ratio(2). The study of acute asthmatic attack in children, showed a high degree of reactive oxygen species formation causing considerable oxidative stress with the high level of oxidants Serum malondialdehyde (MDA) and low level of antioxidants(vitamin C, vitamin E and uric acid)(3). Researchers at the Oslo University Hospital, in the study of children of 7-12 yr with asthma (n = 50) and no asthma (controls) (n = 52)indicated that schoolchildren with asthma and rhinitis had reduced levels of the major serum antioxidant albumin, and poorly controlled asthma was associated with decreased vitamin E and transferrin levels(4).

2. The effects
The Northwestern University study indicated the opposing regulatory effects as allergic inflammation is inhibited by supplementation with the purified natural vitamin E isoform α-tocopherol but elevated by the isoform γ-tocopherol when administered at physiological tissue concentrations(5)(6). But according to University of North Carolina School of Medicine, γ-tocopherol (GT) significantly decreased (p < 0.05) internalization of attached zymosan bioparticles and macrophage expression of CD206, CD36 and CD86 in allergic asthmatics through downregulation of both innate and adaptive immune response elements, and atopic status(7).  The composition containing 623 mg of gamma-tocopherol, 61.1 mg of d-alpha-tocopherol, 11.1 mg of d-beta-tocopherol (11.1 mg), and 231 mg of d-sigma-tocopherol capsule in Phase I human dosing study showed the decreased systemic oxidative stress, increased serum levels of gamma-tocopherol, and inhibited monocyte responses to LPS without any adverse health effects(8). IOvalbumin (OVA)-sensitized Brown Norway rats, treatment of gamma-tocopherol (gammaT), inhibited the pathogenesis of both AR and asthma inflammatory pathways(9). Suggestion of oxidant stress and diminished antioxidant defenses may be a cause of asthmatic disease(10) and uncontrolled asthma and severe asthma pattern have impaired antioxidant defenses and are thus most susceptible to the damaging effects of oxidative stress(11). 1500 IU of natural-source d-α-tocopheryl acetate daily for at least 16 weeks in volunteered asthmatic patient, showed to inhibited oxidant stress, through  modulation of allergic inflammation and airway hyperresponsiveness in human atopic asthmatics in vivo(12).

Taken altogether, Aγ-tocopherol, a variant of vitamin E, may be effective in reduced risk and treatment of asthmatic disorder, but further large sample and in multi centers studies are necessary to validate it claims. Over doses of vitamin E supplement can cause symptoms of blurred vision, weakness, dizziness, nausea, diarrhea, etc., please make sure you follow the guideline of the Institute of Medicine of the National Academies.

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(a) Vitamin E supplements in asthma: a parallel group randomised placebo controlled trial by Pearson PJ1, Lewis SA, Britton J, Fogarty A(PubMed)
(b) Effects of vitamin E on mitochondrial dysfunction and asthma features in an experimental allergic murine model by Mabalirajan U1, Aich J, Leishangthem GD, Sharma SK, Dinda AK, Ghosh B.(PubMed)
(c) Diet and asthma: vitamins and methyl donors by Han YY1, Blatter J1, Brehm JM1, Forno E1, Litonjua AA2, Celedón JC3.(PubMed)
(d) Asthma, allergy, and responses to methyl donor supplements and nutrients by Sharma S1, Litonjua A(PubMed)
(e) Vitamin e supplementation, lung functions and clinical manifestations in children with moderate asthma: a randomized double blind placebo- controlled trial by Ghaffari J1, Farid Hossiani R, Khalilian A, Nahanmoghadam N, Salehifar E, Rafatpanah H.(PubMed)
(1) Serum vitamin E concentrations at 1 year and risk of atopy, atopic dermatitis, wheezing, and asthma in childhood: the PASTURE study by Nwaru BI1, Virtanen SM, Alfthan G, Karvonen AM, Genuneit J, Lauener RP, Dalphin JC, Hyvärinen A, Pfefferle P, Riedler J, Weber J, Roduit C, Kaulek V, Braun-Fahrländer C, von Mutius E, Pekkanen J; PASTURE study group.(PubMed)
(1a) Association of serum carotenoids and tocopherols with atopic diseases in Japanese children and adolescents by Okuda M1, Bando N, Terao J, Sasaki S, Sugiyama S, Kunitsugu I, Hobara T.(PubMed)
(2) Vitamin e supplementation, lung functions and clinical manifestations in children with moderate asthma: a randomized double blind placebo- controlled trial by Ghaffari J1, Farid Hossiani R, Khalilian A, Nahanmoghadam N, Salehifar E, Rafatpanah H.(PubMed)
(3) Antioxidant status in acute asthmatic attack in children by Al-Abdulla NO1, Al Naama LM, Hassan MK.(PubMed)
(4) Altered oxidative state in schoolchildren with asthma and allergic rhinitis by Bakkeheim E1, Mowinckel P, Carlsen KH, Burney P, Carlsen KC.(PubMed)
(5) Vitamin E isoforms as modulators of lung inflammation by Abdala-Valencia H1, Berdnikovs S, Cook-Mills JM.(PubMed)
(6) Two faces of vitamin E in the lung by Cook-Mills JM1, Abdala-Valencia H, Hartert T.(PubMed)
(7) Effects of ex vivo γ-tocopherol on airway macrophage function in healthy and mild allergic asthmatics by Geiser M1, Lay JC, Bennett WD, Zhou H, Wang X, Peden DB, Alexis NE.(PubMed)
(8) In vivo gamma-tocopherol supplementation decreases systemic oxidative stress and cytokine responses of human monocytes in normal and asthmatic subjects by Wiser J1, Alexis NE, Jiang Q, Wu W, Robinette C, Roubey R, Peden DB.(PubMed)
(9) Gamma-tocopherol prevents airway eosinophilia and mucous cell hyperplasia in experimentally induced allergic rhinitis and asthma by Wagner JG1, Jiang Q, Harkema JR, Ames BN, Illek B, Roubey RA, Peden DB.(PubMed)
(10) Oxidative stress and antioxidant status in Saudi asthmatic patients by Al-Afaleg NO1, Al-Senaidy A, El-Ansary A.(PubMed)
(11) Reduced circulating antioxidant defences are associated with airway hyper-responsiveness, poor control and severe disease pattern in asthma by Wood LG1, Gibson PG.(PubMed)
(12) Natural-source d-α-tocopheryl acetate inhibits oxidant stress and modulates atopic asthma in humans in vivo by Hoskins A1, Roberts JL 2nd, Milne G, Choi L, Dworski R.(PubMed)

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